Pernicious Anemia Presented with Isolated Nominal Dysphasia in Type Ill Polyglandular Failure Female Patient

Abstract

Pernicious anemia (also known as Biermer’s disease) is an autoimmune atrophic gastritis which predominantly affects the fundus of the stomach. It results in a deficiency of vitamin B12 (cobalamin) as it affects the normal process of absorption in the ileum. The pernicious anemia is characterized by a wide range of hematological and neurological features. Neurological features can present without hematological manifestations. One of the early neurological features of this anemia is nominal dysphasia (word-finding difficulties), which was usually not reported before as an isolated finding. We present a case of pernicious anemia with isolated nominal dysphasia responding dramatically to parenteral vitamin B12 therapy.

Pernicious Anaemia: Mechanisms, Diagnosis, and Management

“…[26][27][28][29][30][31] Isolated cases of nominal dysphasia or amnesic aphasia were reported. 32,33 A minority of patients exhibit mental or psychiatric disturbances (psychosis) or autonomic signs (bladder, erectile dysfunction, and orthostatic hypotension). Additionally, patients with PA must be closely observed for hypotension and it is also advisable to screen patients with chronic postural hypotension for vitamin B12 deficiency.…”